Vitamin K deficiency bleeding (VKDB), a completely preventable condition that can leave infants permanently disabled, can occur when parents refuse intramuscular vitamin K injections for their newborns. In this 150-Second Analysis, F. Perry Wilson, MD, discusses a new study examining the rates and risk factors for refusal.
This is vitamin K.
Vitamin K is a friendly, fat-soluble vitamin. Without it, your blood will stop clotting and you die.
You can find vitamin K in all sorts of good things, like kale
and other green leafy vegetables, and some gross things like liver.
You can also find vitamin K in this form:
This form of vitamin K -- an intramuscular injection -- has been recommended for newborns by the American Academy of Pediatrics since 1961.
Newborns have low reserves of vitamin K. Without this shot, they are prone to a condition called , which can cause intracranial hemorrhage and lifelong disability or death. VKDB had been, essentially, eradicated.
That is, until recently, when new cases started popping up – :
Why are we seeing a resurgence in this totally preventable disease? Because parents have started to refuse to allow their newborns to receive vitamin K injections, as revealed in this paper appearing in the journal Pediatrics.
The researchers examined the birth records of nearly 103,000 newborns from centers participating in the . Of those, 638, 0.6%, had parents who refused vitamin K injections.
I know what you're thinking -- that's less than 1 in 100. You're right -- it's not too bad. But the refusal behavior is associated with a variety of other dangerous behaviors.
For example, 82% of the vitamin K refusers also refused ocular prophylaxis for gonococcal ophthalmia neonatorum, which can result in permanent blindness. And 74% of the vitamin K refusers also refused hepatitis B vaccination.
The study examined the characteristics of the refusers. Consistent with prior research, those who refused vitamin K shots were more likely to be non-Hispanic whites, to have private insurance, and to plan to feed the newborn only with breast milk. This is ironic, as formula has substantially more vitamin K than breast milk does.
I asked lead author Dr. Jaspreet Loyal what is behind these refusals.
"Vitamin K is a victim in a sense, as there are many families that think that vitamin K is a vaccine and a lot of fear comes from that perception in some cases. I don't think that prominent individuals speaking about vaccines in a negative way helps the situation."
No. It certainly does not.
Vitamin K refusal is a symptom of a bigger problem – mistrust of the medical establishment. It is a mistrust born out of our failure to connect with our patients in the context of the 10-minute visits mandated by our administrators and by the vicissitudes of payer reimbursement rates. And it is exacerbated by a diet, supplement, and alternative medicine industry that depends on undercutting established medical science for their own profits. We need to address these issues head on. If not, our patients -- and their children -- will pay for it.
, is an assistant professor of medicine at the Yale School of Medicine. He is a 51˶ reviewer, and in addition to his video analyses, he authors a blog, . You can follow .